DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20203430

Study of prognostic importance of hs-CRP levels in acute stroke patients coming to Theerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh, India

Bajranglal Banthia, Saad Mohammad Shakir

Abstract


Background: Stroke has been found to be the fourth most fatal cause of death around the globe. Decreased activity and physical work are the major causes of increased incidences of stoke worldwide. It has also been studied that elevated levels of high-sensitivity C-reactive protein (hs-CRP) have been related to vascular inflammation whereas CRP is an important biomarker of systemic inflammation. Aim of this study to measure serum high-sensitivity C-reactive protein (hs-CRP) levels in the patients presenting with stroke, and evaluating its correlation as a prognostic marker in stroke patients.

Methods: It was an observational prospective hospital-based case study carried out at Teerthanker Mahaveer Medical College and Research Centre, a tertiary care hospital situated in Moradabad, India for 5 months period from 1st November 2018 to 31st March 2019. 100 patients of new-onset stroke were included in the study.

Results: According to the Scandinavian score, the majority of the patients who had ischemic stroke depicted a score range from 2-8. On the other hand, the majority the patients with hemorrhagic score had a Scandinavian score >14. The mean hs-CRP, when observed between different ranges of the Scandinavian score, showed that in 2-8 range the mean hs-CRP was 31.49±15.00, the mean hs-CRP for 9-14 range was 7.99±6.32 and the mean hs-CRP for >14 range was 7.10±0.32.

Conclusions: It can be identified that levels of hs-CRP can be used as a marker to predict the long term prognosis of patients with stroke. In addition to this, it can also be identified that patients with higher levels of hs-CRP have lower Scandinavian score and the patients with lower hs-CRP levels have a higher Scandinavian score. Also, the results show that patients with ischaemic stroke have higher hs-CRP levels as compared to hemorrhagic stroke.


Keywords


hs-CRP, Stroke, Hemorrhagic stroke, Ischemic stroke, Scandinavian score

Full Text:

PDF

References


Di Napoli M, Schwaninger M, Cappelli R, Ceccarelli E, Di Gianfilippo G, Donati C, et al. Evaluation of C-reactive protein measurement for assessing the risk and prognosis in ischemic stroke: a statement for health care professionals from the CRP Pooling Project members. Stroke. 2005 Jun 1;36(6):1316-29.

Lal R, Gupta A, Virmani SK, Tyagi VK, Sharma S. High sensitivity C-reactive protein as a prognostic marker in ischaemic and haemorrhagic stroke. IJAM. 2016 Apr;3(2):372.

Sasaki S, Zhang XH, Kesteloot H. Dietary sodium, potassium, saturated fat, alcohol, and stroke mortality. Stroke. 1995 May; 26(5):783-9.

Foroughi M, Akhavanzanjani M, Maghsoudi Z, Ghiasvand R, Khorvash F, Askari G. Stroke and Nutrition: A Review of Studies. Int J Prev Med. 2013;4(Suppl 2):S165-79.

Kannel WB. Framingham study insights into hypertensive risk of cardiovascular disease. Hypertension Resea. 1995;18(3):181-96.

Medeiros F, Casanova MD, Fraulob JC, Trindade M. How Can Diet Influence the Risk of Stroke? Intern J Hypertension. 2012 Apr;2012.

VanGilder RL, Davidov DM, Stinehart KR, Huber JD, Turner RC, Wilson KS. et al. C-reactive protein and long-term ischemic stroke prognosis. J Clin Neurosci. 2014;21(4):547-53.

Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrisons Principle of Internal Medicine. 20th ed, Volume 2: 3068.

Elkind MS, Coates K, Tai W, Paik MC, Boden-Albala B, Sacco RL. Levels of acute phase proteins remain stable after ischemic stroke. BMC Neurology. 2006 Dec 1;6(1):37.

Chaudhuri JR. High sensitivity C-reactive protein levels in Acute Ischemic Stroke and subtypes: A study from a tertiary care center. Iran J Neurol. 2013;12(3):92-7.

Muir KW, Weir CJ, Alwan W, Squire IB, Lees KR. C-reactive protein and outcome after ischemic stroke. Stroke. 1999 May;30(5):981-5.

Mishra PT, Chandra R, Saxena SK, Verma S, Jain R, Bhuyan A. High sensitivity c-reactive protein (hsCRP) level in cerebrovascular accident (Stroke). Age (years). 2010;58:52-76.

Den Hertog HM, Van Rossum JA, Van der Worp HB, Van Gemert HMA, De Jonge R, Koudstaal PJ, et al. C-reactive protein in the very early phase of acute ischemic stroke: association with poor outcome and death. J Neurol. 2009;256(12):2003-8.

Rost NS, Wolf PA, Kase CS, Kelly-Hayes M, Silbershatz H, Massaro JM, et al. Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: the Framingham study. Stroke. 2001 Nov 1;32(11):2575-9.

Ridker PM, Buring JE, Shih J. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation 1998;98(8):731-3.

Rohde LE, Hennekens CH, Ridker PM. Survey of C-reactive protein and cardiovascular risk factors in apparently healthy men. Am J Cardiol. 1999 Nov 1;84(9):1018-22.

Di Napoli M, Papa F, Bocola V. C-reactive protein in ischemic stroke: an independent prognostic factor. Stroke. 2001;32(4):917-24.

Rost NS, Wolf PA, Kase CS, Kelly Hayes M, Silbershatz H, Massaro JM, et al. Plasma concentration of C reactive protein and risk of ischaemic stroke and TIA: the Framingham Study. Stroke. 2011;32:2575-79.

Eikelboom JW, Hankey GJ, Baker RI, McQuillan A, Thom J, Staton J, et al. C-reactive protein in ischaemic stroke and its aetiologic subtypes. J Stroke Cerebrovasc Dis. 2003 Mar 1;12(2):74-81.